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Page 1: SCMSC Membership Application Form

MOTOR SPORT

S U N S H I N E C O A S T

CLUBINC.

Keep up to date and join our facebook group ‘Sunshine Coast Motor Sport Club Inc.’

Applicant Details:

Name DOB / /

Address

Suburb

Postcode Email

Phone

Membership Fee

All memberships $60 per annum. Pay by direct deposit only to the following bank account:

NABSunshine Coast Motor Sport Club Inc.BSB: 084855A/C: 846204971

Please email payment remittance with completed Membership Application Form to [email protected] membership is valid for 12 months from the date received.

Office Use Only

Membership #

Received by on / /

MEMBERSHIPAPPLICATION FORM

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